Evidence of meeting #56 for Health in the 41st Parliament, 1st session. (The original version is on Parliament’s site, as are the minutes.) The winning word was pandemic.
A recording is available from Parliament.
Assistant Director, Gatineau Fire Services, Canadian Association of Fire Chiefs
If I may add quickly....
Activities during a pandemic are managed by both the federal and provincial governments. A pandemic affects the whole country, in various places, while an epidemic is more at a local or provincial level. We came to share our position here, before you, rather than address the provinces, simply because pandemics are managed by the federal government, unless I am mistaken, which I do not think I am.
Thank you.
Conservative
Colin Carrie Conservative Oshawa, ON
It is a partnership between all the different jurisdictions. I understand your interpretation—I do get it—but as I said, we've heard testimony before, and with the guidelines the way they are, if the ultimate goal is that in each jurisdiction professionals should be handled appropriately...regardless of the guidelines the federal government puts in, if we're the source of it, if they don't interpret them the way you would like, then making a change at this level would not make any difference, because they can actually make the changes today.
We're simply one small panel, one small meeting, but because it does include these areas, I'm curious to know whether you have had a chance to—
Conservative
The Chair Conservative Joy Smith
I'm sorry, Dr. Carrie, your time is up. I have to go to Ms. Block. Thank you.
Ms. Block.
Conservative
Kelly Block Conservative Saskatoon—Rosetown—Biggar, SK
Thank you very much, Madam Chair.
I want to thank all of our guests for being here. It has been a good discussion, and I echo my colleague's comments about the important role that our firefighters, our paramedics, and our emergency services play in our communities.
One of the joys of going last is that so many of the questions you may have wanted to ask have already been asked, and I find myself in that situation right now. We're all fairly like-minded in wanting to try to get at a solution that will ensure that all Canadians are protected in the event that we find ourselves facing another pandemic.
It may come as no surprise to any of you that, being a member of Parliament from Saskatoon, I should want to zero in on our paramedic who has put forth some testimony today.
Conservative
Conservative
Kelly Block Conservative Saskatoon—Rosetown—Biggar, SK
Yes, our very robust paramedic, who I must say led all of our MPs and our staff in some CPR training about half a year ago, and it was a great thing for us to do.
I'm very pleased to know that our firefighters in the Saskatoon area received the immunization vaccine. Were you a part of any conversations in the planning? Obviously, this came up quickly, but were you as a paramedic or was M.D. Ambulance involved in bringing forward any suggestions on how it should be handled? And have there been any conversations after the fact about lessons learned and what could be done differently?
Advanced Care Paramedic, M.D. Ambulance Care Ltd.
I'll just touch on the fact that discussions happen maybe one level higher than my pay grade back home. But in a department where I hold my title, I would do the rollout, the immunization, so it gets filtered down.
One thing I saw with H1N1 at the time was the lack even of communication and the difficulty in just receiving vaccinations for ourselves and the red tape we had to go through about where we fall in that. So I can understand from a firefighter's point of view how difficult it would be, communication-wise, when their hands are tied as well by the rollout and the sequencing guidelines that came out.
As a practitioner at arm's length to a lot of this, when I look at it and read the sequencing, to me it's very clear that.... It lists what “pre-hospital patient contact” and “emergency medical services” mean and indicates that the people who are involved in them should be prioritized because our risk factor is so high. Vaccination is not only to protect ourselves but to protect against the spread of the influenza as well. Hitting the people who are going to be exposed to a high number of cases is extremely important.
Now, when in the second tier it listed firefighters, it handcuffed the ability of the provincial or local jurisdictions to give that opportunity to them. They can say that some places did and some places didn't, but in a pandemic, when everyone is rushing to get everything done and there is great concern, that's not the time to make decisions. What's happening here is that we need to re-evaluate, look at what pre-hospital patient contact means in the case of emergency medical services and at the roles that paramedics play and that firefighters play alongside the paramedics.
Every day I go to calls with firefighters, and every day we're all put at risk for anything that could happen there. In our role during a pandemic, bureaucracy and everything aside, with all due respect, we're exposed every day. If we're not given the tools, whether those be gloves, gowns, masks, or vaccinations, then we're putting ourselves at extreme high risk, and not only our own selves and our future patients whom we come in contact with 24 or 48 hours later, but also our families at home.
To wrap it all up, there is a lack of communication at some points and a lack of clarity in documents that filter down. What we're asking for is for some of that communication to be cleared up and for improvement to the consultation process, so that when information is filtered down, things are clearer during a stressful time such as that is.
Conservative
Conservative
The Chair Conservative Joy Smith
Dr. Fry, I have a question, if you would give me some time, and then I'll have you follow it. Is that okay?
Liberal
Hedy Fry Liberal Vancouver Centre, BC
Thank you very much, Madam Chair.
There has been a lot of discussion here today about what epidemiology is about and what the primary principles of public health policy are.
It depends on what the epidemic and pandemic is. H1N1, SARS, etc. were spread through human contact and respiratory droplet infection. But let us imagine, for instance—and I hope not—that massive numbers of people suddenly became ill because of eating E. coli-tainted beef. Touching them isn't going to give you E. coli. You cannot pass it on as a first responder to somebody else.
But in the case of an epidemic that is contact- and droplet-borne, then the people who are in contact with the people who are sick must be protected, and first is to keep them healthy enough to continue to do their work as a first responder, but second—and you said it extremely well, Mr. Hills—they cannot therefore pass it on to other patients. The primary thing we heard Mr. Brown say, heard the chief public health officer say, is that it has to do with protecting people from getting the illness. It therefore means protecting against contact and getting the illness, not simply a certain group of people. If you are in contact with sick people and you pass it on to other people, you are in a very high-risk group in that kind of pandemic.
My question to you is this. Do you believe that what you really would like to see is based on the type of disease or type of pandemic, so that if there is a possibility that there is contact spread, you are deemed to be a first responder because of the nature of the work you do, and that the Public Health Agency, which is supposed to be setting all the guidelines in a pandemic—“guidelines” meaning there is flexibility at the local level. You would like to ensure in such pandemics or such epidemics that you are deemed therefore to be a first responder like other health care professionals?
If that's the simple thing you're asking for, you're not asking for political interference; you're asking to fulfill the objectives of public health principles.
Is that it? Is it that simple?
Assistant to the General President, Canadian Operations, International Association of Fire Fighters
Yes, absolutely. I think we've made the point fairly clearly that what we are looking for is to be considered no different from any other emergency health provider. The reason we're here at the federal level as opposed to the provincial level is that if we go out tomorrow and convince all of our provincial health ministers that firefighters are emergency health providers, and then six months from now a new guideline comes out for a new pandemic and we're listed differently, we're going to have the same confusion. Different public health officers might be in place, or whatever.
Again, if the epidemiology of a virus states that only children are at risk of getting it, then I'm quite certain that the medical people who determine who gets the first priority are going to recognize that within the way they roll it out to all emergency health providers. It doesn't make any sense to me that you would look at a robust firefighter and say that he doesn't need it because he's strong or robust but that this strong, robust emergency physician needs it. That's a factor; it's separate from the occupation. We all deliver emergency medical response; we're all emergency medical responders.
You've hit the nail on the head: that's what we're looking for, the recognition that this is what firefighters do.
Assistant Director, Gatineau Fire Services, Canadian Association of Fire Chiefs
I might add something in regard to flexibility. It's very clear to us that guidelines give flexibility, but guidelines need to be respected up to some point in time. If municipally or provincially they do not follow the guidelines, they will have to answer for their actions.
And of course flexibility is important. Why? It's because there may be one province that, because they're on an island, will not be affected, so they do not need to go to vaccination immediately. That's flexibility, for me.
Liberal
Liberal
Hedy Fry Liberal Vancouver Centre, BC
It's a 10-second thing. You've given other people the ability to go over.
